Stakeholders' perspectives about the impact of training and sensitization of traditional and spiritual healers on mental health and illness: A qualitative evaluation in Ghana.

BACKGROUND: Prayer camps and traditional healers have emerged recently as alternative sources of mental health care in Ghana. To increase their knowledge and collaboration between formal and informal mental health care providers, training and sensitization was organized for them. AIMS: This study aimed at assessing beneficiaries' views about the impact of this intervention. METHODS: We adopted narrative approach to qualitative enquiry using purposive sampling strategy to recruit formal and informal mental health care providers in Ghana for an in-depth interview. We analyzed the data thematically using QSR NVivo 12. RESULTS: Participants enhanced their knowledge about mental health and illness. They reported increased collaboration between formal and informal health care providers. Community psychiatric nurses (CPNs) give injections to patients instead of chaining and using shackles as was initially practiced. There are also regular visits by CPNs to traditional and spiritual healers to discuss the care of the mentally ill patients in their facilities. CONCLUSION: There has been an increased collaboration among healers of mental illness resulting in quick recovery of patients who seek care at traditional and spiritual healers. There is also abolition of chaining and using of shackles by these healers, with increasing respect for the human rights of patients.

Integrated Care: Should It Count as Community Psychiatry Training for Psychiatry Residents?

Psychiatry residents are required to be exposed to community psychiatry. Historically, this occurred in public hospitals or assertive community treatment (ACT) teams. A new model of psychiatric care delivery, integrated care, has become prevalent. While integrated care shares some features with traditional community psychiatry rotations, no research exists to demonstrate if integrated care rotations can accomplish the aims of traditional rotations. This pilot study compared learning outcomes in ACT team rotations versus integrated care rotations. Pre- and post-rotation surveys were disseminated to third-year psychiatry residents (N = 8) who were randomized to complete a rotation with an ACT team or an integrated care team. By rotation end, many in both settings changed how conservative they were in treatment philosophies, but this did not result in a difference between groups. Residents in both groups were satisfied with their rotations. Training in integrated care may be a reasonable alternative to traditional community psychiatry rotations.

A community engaged curriculum for public service psychiatry fellowship training.

Transforming the mental health system into a recovery oriented, integrated system of care requires a psychiatric work force that understands the relationship between recovery processes and community living. Fellowship programs in public and community psychiatry contribute to this transformation by educating psychiatrists about recovery, system dynamics, leadership, effective administration and community involvement. This paper describes a novel approach to fellowship programming that accomplishes these aims through an organizational strategy that emphasizes community engagement. After describing the administrative background for the program, we describe how the content curriculum and teaching process focus on the engagement of community members-both service users and service providers-as participating faculty. The faculty includes over 100 consumers, family members, advocacy group representatives, clinicians, and administrators. We present evaluation data obtained from 45 of the 100 community and university faculty who participated in the first 2 years' of the fellowship and conclude with a critique and recommendations for further progress in community engaged fellowship training.

Community psychiatry: what should future psychiatrists learn?

Community psychiatry training is required by all adult psychiatry residency training programs. Unlike other core elements of training, the specific content is not clearly articulated, leaving program design and content up to individual programs. At the same time, the meaning of "community psychiatry" is increasingly in the eye of the beholder; traditional structures and systems have lost funding, services are more diffuse, and the traditional medical model is becoming less valued. In this column we describe an approach to training in community psychiatry that is intended to prepare future psychiatrists for the clinical and systems challenges they will undoubtedly face and that achieves this goal through trainees' caring for an especially vulnerable subpopulation--homeless individuals with severe and persistent mental illness. We describe how this model teaches residents to think simultaneously at both the individual and the systems levels and enables them to understand the critical need to use nontraditional treatment approaches in order to provide comprehensive care for this marginalized population. We believe that this clinical and training paradigm can be replicated and might guide other residency training programs in their approach to teaching community psychiatry.

Integrated primary mental health care

Mental health is increasingly being recognised as contributing significantly to the burden of disease, particularly now that the indicators have shifted from measures of mortality to measures of morbidity. Psychiatric morbidity in the community, based on community surveys, is estimated at 20 to 30 percent of the population. Increasingly, patients needing health services prefer to be in a general health care setting than in specialized centres. Internationally and regionally, the general policy has been to move toward the development of comprehensive mental health programmes integrated within primary health care. This integration may be structural (use of shared facilities), administrative (shared administrative resources) or functional (complete integration of clinical services, with staff jointly responsible for patient welfare). This paper examines how this integration can be achieved, and the potential role of the Department of Community Health and Psychiatry, University of the West Indies in advancing this integrative process through research and training.(AU)

Integrated primary mental health care

Mental health is increasingly being recognized as contributing significantly to the burden of disease, particularly now that the indicators have shifted from measures of mortality to measures of morbidity. Psychiatric morbidity in the community, based on community surveys, is estimated at 20 to 30of the population. Increasingly, patients needing mental health services prefer to be in a general health care setting than in specialized centres. Internationally and regionally, the general policy has been to move toward the development of comprehensive mental health programmes integrated within primary health care. This integration may be structural (use of shared facilities), administrative (shared administrative resources) or functional (complete integration of clinical services, with staff jointly responsible for patient welfare). This paper examines how this integration can be achieved, and the potential role of the Department of Community Health and Psychiatry, University of the West Indies in advancing this integrative process through research and training.

Integrated primary mental health care.

Mental health is increasingly being recognized as contributing significantly to the burden of disease, particularly now that the indicators have shifted from measures of mortality to measures of morbidity. Psychiatric morbidity in the community, based on community surveys, is estimated at 20 to 30% of the population. Increasingly, patients needing mental health services prefer to be in a general health care setting than in specialized centres. Internationally and regionally, the general policy has been to move toward the development of comprehensive mental health programmes integrated within primary health care. This integration may be structural (use of shared facilities), administrative (shared administrative resources) or functional (complete integration of clinical services, with staff jointly responsible for patient welfare). This paper examines how this integration can be achieved, and the potential role of the Department of Community Health and Psychiatry, University of the West Indies in advancing this integrative process through research and training.

Vigencia del pensamiento de Honorio Delgado en la psiquiatría contemporánea / Relevance of Honorio Delgado thought on the contemporary psychiatry

Se revisa y pone de relieve la vigencia del pensamiento escrito de Honorio Delgado en la psiquiatría contemporánea, a nivel peruano, latinoamericano y universal, desde cuatro perspectivas: las de Delgado en tanto que psiquiatra crítico, innovador, ecléctico y visionario. Se enfatiza las diversas facetas de su magisterio en los grandes renglones de la psiquiatría moderna: psiquiatría clínica, psiquiatría biológica, medicina psicosomática, psicoterapia, psiquiatría social y educación psiquiátrica. Se establece la plena actualidad de su contribución en base a lo que los líderes de la psiquiatría universal contemporánea sostiene respecto a nuestra disciplina. La obra de Delgado debe ser objeto de estudio, escrutinio y crítica en tanto estos estén a su altura y representen la superación dialéctica del conocimiento que él abordó con libertad de espíritu, crítica sólida, afán innovador, eclecticismo sobrio y una esperanza siempre reiterada de mejoramiento (AU)

Vigencia del pensamiento de Honorio Delgado en la psiquiatría contemporánea / Relevance of Honorio Delgado thought on the contemporary psychiatry

Se revisa y pone de relieve la vigencia del pensamiento escrito de Honorio Delgado en la psiquiatría contemporánea, a nivel peruano, latinoamericano y universal, desde cuatro perspectivas: las de Delgado en tanto que psiquiatra crítico, innovador, ecléctico y visionario. Se enfatiza las diversas facetas de su magisterio en los grandes renglones de la psiquiatría moderna: psiquiatría clínica, psiquiatría biológica, medicina psicosomática, psicoterapia, psiquiatría social y educación psiquiátrica. Se establece la plena actualidad de su contribución en base a lo que los líderes de la psiquiatría universal contemporánea sostiene respecto a nuestra disciplina. La obra de Delgado debe ser objeto de estudio, escrutinio y crítica en tanto estos estén a su altura y representen la superación dialéctica del conocimiento que él abordó con libertad de espíritu, crítica sólida, afán innovador, eclecticismo sobrio y una esperanza siempre reiterada de mejoramiento